Health care act details, costs emerge

North Carolinians who purchase health insurance through the new marketplace exchange will pay rates above the national average. Nevertheless, it appears they will be able to get coverage at prices they can afford.

The average monthly premium for a mid-range plan will be $369 a month, the U.S. Department of Health and Human Services said, as compared to an average of $328 across the 36 states in which the federal government runs the exchanges.

However, only individuals and families making more than four times the federal poverty level will pay that much. Others will receive subsidies on a sliding scale. Many lower-income people will pay nothing.

There are five levels of coverage. Catastrophic plans, designed for people under age 30 and those with very low incomes; have large deductibles and cover just three primary care visits a year but provide a cushion against ruinous bills. The average monthly cost for such a policy in North Carolina is $123 before subsidies.

The cost also will vary depending on age, income, county of residence, deductibles and how many physicians consumers want included in their network. It will not, however, vary due to gender or pre-existing conditions.

Additional benefits include protections against unreasonable premium increases, preventive care with no deductible or co-pay, and an end to lifetime benefit limits.

North Carolina has 1.35 million people eligible, or 17 percent of the population, according to HHS. Of those, nearly one million have a worker in the family. So much for the claims by Affordable Care Act foes that the benefits will go to welfare bums.

More than 90 percent of those eligible should be able to get coverage though a private insurer or Medicaid. That will not be the case, however, because North Carolina refused to increase Medicaid eligibility to 135 percent of the poverty level. That questionable decision will leave as many as 500,000 of the working poor without coverage.

State hostility might also be a factor in above-average rates. Only two insurers are offering coverage in North Carolina and only one of them, Blue Cross Blue Shield, is writing coverage in all 100 counties. Coventry Health Care will serve 39 counties, including Buncombe. The Blues offer 26 different plans while Coventry has 25.

Had the state operated the exchange and encouraged insurers to sign up, there might have been greater competition and lower prices.

The complexity of the Affordable Care Act has left a lot of people confused. On top of that, opponents of the act have mounted a well-funded misinformation campaign. Fortunately, there are plenty of places to go for accurate information.

Organizations receiving grants to help guide people through the process include Mountain Projects, with offices in Waynesville and Sylva, and North Carolina Community Care Networks, an umbrella for groups including Pisgah Legal Services and the Council on Aging of Buncombe County.

The Alcohol/Drug Council of North Carolina will concentrate on "people in recovery from mental illness and/or substance abuse."

The American Association of Retired Persons has a website, healthlawanswers.org, so well-designed HHS has recommended it. The Blues have a video on their website, bcbsnc.com, and also a Blue Map feature providing individualized answers.

Signup begins Tuesday and the law's requirement to be insured goes into effect Jan. 1. No matter what the ACA foes say, the law is not going to go away, and it is to your benefit to be insured. So get on board.

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Health care act details, costs emerge

North Carolinians who purchase health insurance through the new marketplace exchange will pay rates above the national average. Nevertheless, it appears they will be able to get coverage at prices